Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

602 questions · 963 findings · 90 reviews

No studies found 118 · 12.3%GRADE not reported 578 · 60%Very low 93 · 9.7%Low 92 · 9.6%Moderate 59 · 6.1%High 23 · 2.4%

Quantitative light-induced fluorescence (QLF) vs Reference standard (histology; some ICDAS/radiography)

Occlusal caries detection: specificity · Extracted human teeth (in vitro); permanent and primary teeth, occlusal surfaces

In vitro, QLF pooled specificity for occlusal caries in permanent teeth was 0.66 (3 studies; ungraded).

3 findings from 1 review

Quantitative light-induced fluorescence (QLF) vs Reference standard (bitewing radiography, ADA classification, ICDAS II)

Occlusal caries detection: sensitivity · Patients (in vivo); permanent and primary teeth, occlusal surfaces

In vivo, QLF pooled sensitivity for occlusal caries detection was 0.86 (4 studies; ungraded).

2 findings from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Specificity · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms have high pooled specificity (0.90) for detecting dental caries; ungraded, with very high heterogeneity (I2>95%).

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Area under the summary ROC curve · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

The area under the summary ROC curve for AI caries detection is 0.86, indicating high overall diagnostic accuracy; ungraded.

1 finding from 1 review

Quantitative light-induced fluorescence (QLF) vs Reference standard (histology; some ICDAS/radiography)

Proximal caries detection: specificity · Extracted human teeth (in vitro); permanent teeth, proximal (approximal) surfaces

In vitro, QLF pooled specificity for proximal caries detection was 0.74 (3 permanent-teeth studies; no primary-dentition data; ungraded).

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Positive likelihood ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

A positive AI test raises caries probability substantially (LR+ 10.44; positive post-test probability 79%); ungraded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Log diagnostic odds ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms show strong pooled discriminative accuracy for dental caries (log DOR 4.37; DOR 70.9); ungraded.

1 finding from 1 review

Quantitative light-induced fluorescence (QLF) vs Reference standard (bitewing radiography, ADA classification, ICDAS II)

Proximal caries detection: sensitivity · Patients (in vivo); permanent and primary teeth, proximal (approximal) surfaces

In vivo, QLF pooled sensitivity for proximal caries detection was 0.74 (4 studies; ungraded).

2 findings from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Negative likelihood ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

A negative AI test lowers caries probability substantially (LR- 0.17; negative post-test probability 6%); ungraded.

1 finding from 1 review

Nano-hydroxyapatite (nHA) dentifrice/paste (fluoride-free or fluoridated) vs nHA-free / fluoride-free (negative) control

Mineral loss (transversal microradiography) · Enamel/dentin specimens with initial caries lesions (or sound surfaces) in intraoral (in situ) appliances worn by patients

Under remineralizing conditions, nHA produced significantly more remineralization than the negative control (MD 350, 95% CI 179 to 521; very low certainty).

2 findings from 1 review

Metal-free single crowns (full-contour zirconia) vs Composite strip crown

Treatment failure (annual failure rate) · Children (aged 3-5.5 years) with early childhood caries in anterior primary teeth (>=2 carious surfaces), no pulp therapy

Zirconia crowns failed less than composite strip crowns (3.3% vs 15% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Fluoride-free nano-hydroxyapatite (nHA) dentifrice/paste vs Sodium fluoride (control) toothpaste

Mineral loss (transversal microradiography) · Enamel/dentin specimens with initial caries lesions (or sound surfaces) in intraoral (in situ) appliances worn by patients

Under demineralizing conditions, nHA allowed significantly more enamel demineralization than NaF (MD 1625, 95% CI 553 to 2697; very low certainty).

2 findings from 1 review

Hall technique vs Compomer restoration or non-restorative caries treatment

Treatment failure (annual failure rate) · Children (aged 3-8 years) with 2-surface occluso-proximal dentine caries in primary molars, no pulp therapy

Preformed metal (Hall) crowns had a low reported annual failure rate (3.1%) versus compomer (14.7%) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Resin-based fissure sealant vs Fluoride varnish

Caries incidence of first permanent molars (FPMs) · Schoolchildren aged 6-12 years with sound occlusal surfaces of the first permanent molars

Pit and fissure sealant and fluoride varnish showed no statistically significant difference in caries incidence of first permanent molars at 24 months (RR 0.65, 95% CI 0.31 to 1.38; I2=89%; not GRADE-rated).

1 finding from 1 review

Analogue (conventional) radiographs vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
17 findings from 1 review
Show 14 more findings

Cone beam computed tomography (CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
3 findings from 1 review

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
2 findings from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies) · Permanent dentition
    Permanent dentition (4 studies): sensitivity ranged from 0.55 to 0.65.
    4 studies
    GRADE not reported
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies) · Primary dentition
    Primary dentition (3 studies): sensitivity ranged from 0.91 to 0.93. No evidence of a difference in accuracy by dentition (removing accuracy covariate: Chi2=3.15, df=1, P=0.08).
    3 studies
    GRADE not reported

Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
17 findings from 1 review
Show 14 more findings

CarieScan Pro device vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    CarieScan Pro (3 studies, 244 tooth surfaces): sensitivity ranged from 0.55 to 0.91. No evidence of a difference in accuracy by device type (Chi2=0.05, df=1, P=0.82).
    3 studies
    GRADE not reported